PMID- 34049983
OWN - NLM
STAT- MEDLINE
DCOM- 20220301
LR  - 20220301
IS  - 1535-5667 (Electronic)
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 63
IP  - 2
DP  - 2022 Feb
TI  - Efficacy and Safety of (177)Lu-DOTATATE in Lung Neuroendocrine Tumors: A Bicenter 
      study.
PG  - 218-225
LID - 10.2967/jnumed.120.260760 [doi]
AB  - The purpose of this study was to assess the efficacy and safety of 
      (177)Lu-DOTATATE in patients with somatostatin receptor (SSR)-positive lung 
      neuroendocrine tumors (NETs). Methods: This is a retrospective review of the 
      outcome of patients with typical carcinoid (TC) and atypical carcinoid (AC), 
      treated with (177)Lu-DOTATATE at 2 ENETS Centers of Excellence. Morphologic 
      imaging (RECIST 1.1) and (68)Ga-DOTATATE PET/CT responses were assessed at 3 mo 
      after completion of (177)Lu-DOTATATE. Concordance between 2 response assessment 
      methods was evaluated by kappa statistics. Progression-free survival (PFS) and 
      overall survival (OS) were estimated by Kaplan-Meier analysis and compared by 
      Log-rank test. Treatment-related adverse events (AEs) were graded based on Common 
      Terminology Criteria for Adverse Events, version 5. Results: Of 48 patients 
      (median age, 63 y; 13 women), 43 (90%) had AC and 5 (10%) TC. Almost all patients 
      (47, 98%) were treated due to progression. Most patients (40, 83%) received 
      somatostatin analogs, and 10 patients (20%) had prior everolimus, chemotherapy, 
      or both. All patients had high SSR expression (>/= modified Krenning score 3) on 
      pretreatment (68)Ga-DOTATATE PET/CT. Patients received a median 4 (range, 1-4) 
      cycles of (177)Lu-DOTATATE (33% with concurrent radiosensitizing chemotherapy) to 
      a median cumulative activity of 27 GBq (range, 6-43GBq). At a median follow-up of 
      42 mo, the median PFS and OS were 23 mo (95% CI, 18-28 mo) and 59 mo (95% CI, 
      50-not reached [NR]), respectively. Of 40 patients with RECIST-measurable disease 
      and 39 patients with available (68)Ga-DOTATATE PET/CT, response categories were 
      partial response, 20% (95% CI, 10%-35%) and 44% (95% CI, 30%-59%); stable 
      disease, 68% (95% CI, 52%-80%) and 44% (95% CI, 30%-59%); and progressive 
      disease, 12% (95% CI, 5%-27%) by both, respectively. There was a moderate 
      concordance between response categories by RECIST and (68)Ga-DOTATATE PET/CT, 
      weighted kappa of 0.51 (95% CI, 0.21-0.68). Of patients with stable disease by 
      RECIST, those with partial response on (68)Ga-DOTATATE PET/CT had a longer OS 
      than those with no response, NR versus 52 mo (95% CI, 28-64), hazard ratio 0.2 
      (95% CI, 0.1-0.6), P < 0.001. Most grade 3/4 AEs were reversible and the most 
      common was lymphopenia (14%) with no incidence of myelodysplasia or leukemia. 
      Conclusion: In patients with advanced progressive lung NET and satisfactory SSR 
      expression, (177)Lu-DOTATATE is effective and safe with a high disease control 
      rate and encouraging PFS and OS.
CI  - (c) 2022 by the Society of Nuclear Medicine and Molecular Imaging.
FAU - Zidan, Lamiaa
AU  - Zidan L
AD  - Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer 
      Centre, Melbourne, Victoria, Australia.
FAU - Iravani, Amir
AU  - Iravani A
AD  - Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer 
      Centre, Melbourne, Victoria, Australia; Amir.iravani@wustl.edu.
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Melbourne, Victoria, Australia.
AD  - Washington University School of Medicine, Mallinckrodt Institute of Radiology, 
      St. Louis, Missouri.
FAU - Oleinikov, Kira
AU  - Oleinikov K
AD  - Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of 
      Endocrinology and Metabolism, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel.
FAU - Ben-Haim, Simona
AU  - Ben-Haim S
AD  - Department of Nuclear Medicine, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel.
AD  - Institute of Nuclear Medicine, University College London and UCL Hospitals NHS 
      Trust, London United Kingdom.
FAU - Gross, David J
AU  - Gross DJ
AD  - Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of 
      Endocrinology and Metabolism, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel.
FAU - Meirovitz, Amichay
AU  - Meirovitz A
AD  - Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel; and.
FAU - Maimon, Ophra
AU  - Maimon O
AD  - Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel; and.
FAU - Akhurst, Tim
AU  - Akhurst T
AD  - Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer 
      Centre, Melbourne, Victoria, Australia.
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Melbourne, Victoria, Australia.
FAU - Michael, Michael
AU  - Michael M
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Melbourne, Victoria, Australia.
AD  - Division of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, 
      Australia.
FAU - Hicks, Rodney J
AU  - Hicks RJ
AD  - Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer 
      Centre, Melbourne, Victoria, Australia.
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Melbourne, Victoria, Australia.
FAU - Grozinsky-Glasberg, Simona
AU  - Grozinsky-Glasberg S
AD  - Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of 
      Endocrinology and Metabolism, Hadassah-Hebrew University Medical Center, 
      Jerusalem, Israel.
FAU - Kong, Grace
AU  - Kong G
AD  - Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer 
      Centre, Melbourne, Victoria, Australia.
AD  - Sir Peter MacCallum Department of Oncology, The University of Melbourne, 
      Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210528
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Ga(III)-DOTATOC)
RN  - 0 (Organometallic Compounds)
RN  - 0 (Radiopharmaceuticals)
RN  - AE221IM3BB (lutetium Lu 177 dotatate)
RN  - RWM8CCW8GP (Octreotide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/diagnostic imaging/mortality/*radiotherapy
MH  - Male
MH  - Middle Aged
MH  - Neuroendocrine Tumors/diagnostic imaging/mortality/*radiotherapy
MH  - Octreotide/adverse effects/*analogs & derivatives/therapeutic use
MH  - Organometallic Compounds/adverse effects/*therapeutic use
MH  - Positron Emission Tomography Computed Tomography
MH  - Radiopharmaceuticals/*therapeutic use
MH  - Retrospective Studies
PMC - PMC8805789
OTO - NOTNLM
OT  - bronchial carcinoid
OT  - lung neuroendocrine tumor
OT  - peptide receptor radionuclide therapy
OT  - somatostatin receptor
EDAT- 2021/05/30 06:00
MHDA- 2022/03/03 06:00
PMCR- 2022/02/01
CRDT- 2021/05/29 05:41
PHST- 2020/11/21 00:00 [received]
PHST- 2021/04/21 00:00 [revised]
PHST- 2021/05/30 06:00 [pubmed]
PHST- 2022/03/03 06:00 [medline]
PHST- 2021/05/29 05:41 [entrez]
PHST- 2022/02/01 00:00 [pmc-release]
AID - jnumed.120.260760 [pii]
AID - 260760 [pii]
AID - 10.2967/jnumed.120.260760 [doi]
PST - ppublish
SO  - J Nucl Med. 2022 Feb;63(2):218-225. doi: 10.2967/jnumed.120.260760. Epub 2021 May 
      28.